# DENTAL ASSOCIATES PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dental Associates PA
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750484853
- **Authorized official:** DR. DAVID A. SUDIMACK D.D.S. (PRESIDENT)
- **Authorized official phone:** (575) 522-7320

## Contact information

- **Practice address:** 2205 S SOLANO DR, LAS CRUCES, NM 88001
- **Practice address phone:** (505) 522-7320
- **Practice address fax:** (505) 522-6395
- **Mailing address:** 2205 S SOLANO DR, LAS CRUCES, NM 88001
- **Mailing address phone:** (505) 522-7320
- **Mailing address fax:** (505) 522-6395

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | NM1518 | NM | — |
| 1223G0001X | General Practice Dentistry | NM2258 | NM | Yes |

## Other

- **Enumeration date:** 09/06/2006
- **Last updated:** 11/08/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 806920 | UNITED CONCORDIA INS | — |
| 01 | — | 8403 | BLUE CROSS BLUE SHIELD | NM |